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Immigrant Access to Healthcare

Immigrant workers and their families may have questions about whether seeking healthcare may result in their immigration status being discovered, or, worse, that they may be picked up by Immigration and Customs Enforcement (“ICE”) while trying to get healthcare. It is very important for everyone in our communities to continue to seek treatment, preventative care, and immunizations, for their own health, the health and safety of their loved ones, and everyone around them. There are many reasons to feel confident that getting healthcare is a safe thing to do—regardless of immigration status.

HIPAA Privacy Protections

The Health Insurance Portability and Accountability Act (“HIPAA”) provides strong privacy protections. It prohibits medical providers from disclosing any personal identifying information to third parties, including ICE and other law enforcement. However there are important exceptions to this rule. A provider can disclose information when:

required by a subpoena, administrative request or warrant;

when the disclosure is needed to avert a threat to the health and safety of a person; or

when the patient has escaped from detention or a correctional facility; and

the provider believes the information shows evidence of criminal conduct that occurred at the premises of the health facility.

There are other less relevant exceptions as well. While there are rare exceptions, normally all of us, including undocumented immigrants can expect and demand that our personal information is kept confidential.

You Control Whether to Share your Immigration Status Information

Everyone should understand that they have total control over when and how to share their personal information, including their immigration status, social security number, etc. Normally, there is no need to share immigration status with any medical provider. There is no need to share immigration status, and you should not share that information because there is no reason to do so in the context of obtaining healthcare.
While information about the immigration status of a documented person is required to obtain some government-supported health insurance and to use the Covered California exchange, an undocumented person cannot obtain this insurance, and should have no reason to share their own immigration status. In California, children who qualify are eligible for full-scope Medi-Cal regardless of their immigration status.

If an undocumented person is applying for insurance for a family member, they do not need to share their own status during that process.

2011 ICE Policy Not to Arrest People at Medical Care Facilities

It’s also important for people to understand that, pursuant to its 2011 “Sensitive Locations Memo” ICE has a policy of not conducting enforcement actions at “sensitive locations” such as hospitals, doctors’ offices, and accredited medical care facilities. ICE recently stated that this policy is still in effect. ICE officers are supposed to seek special permission from supervisors if there is an important reason to conduct enforcement at a sensitive location. While the Trump administration could change this policy, so far it appears that they do not plan to do so. For this reason, community members should expect that ICE should generally stay away from hospitals and not conduct arrests there, and certainly not raids, at those locations. Should ICE approach a health care facility, showing a copy of the 2011 Sensitive Locations Memo may help prevent enforcement at such locations. A copy of the memo can be found here: https://www.ice.gov/doclib/ero-outreach/pdf/10029.2-policy.pdf

Our Immigrant Community Has Power and Influence within Our Medical Facilities

Finally, community members should remember that we are strong in numbers, and have the power to advocate as patients at our own health care facilities. Many medical care facilities have been rewriting and clarifying their privacy policies and practices in order to ensure that their immigrant patients are protected. Some health care facilities are doing outreach to educate their communities about their practices so that people feel safe to get care. Community members should feel empowered to encourage their medical providers to engage in these and similar activities. Patients can also ask about their provider’s policies.

It’s very important for our community to keep getting healthcare. Hospitals and medical facilities are one of the safest places to go, and patients have total control over how much information they share. Don’t let the Trump administration intimidate us from living a full and healthy life—this is our home!

For any questions, please contact your immigration or labor law counsel.